|
Ultrasound guidance for vascular access
|
$19,912.36 |
$19,912.36 |
$19,912.36 |
$388.08
|
|
Ultrasound hips infant dynamic
|
$740.35 |
$740.35 |
$740.35 |
$403.88
|
|
Ultrasound joint complete left
|
$425.75 |
$425.75 |
$425.75 |
$557.99
|
|
Ultrasound pregnant uterus < 14 weeks each additional gestation
|
$193.70 |
$193.70 |
$193.70 |
$335.00
|
|
Ultrasound pregnant uterus detailed fetal exam single/1st gestation
|
$1,131.65 |
$1,131.65 |
$1,131.65 |
$707.20
|
|
Ultrasound pregnant uterus follow up per fetus
|
$429.00 |
$429.00 |
$429.00 |
$425.60
|
|
Ultrasound prostate/transrectal
|
$87.10 |
$87.10 |
$87.10 |
$557.40
|
|
Ultrasound spinal canal and contents
|
$396.50 |
$396.50 |
$396.50 |
$463.00
|
|
Ultrasound transabd ea addl gest
|
$553.80 |
$553.80 |
$553.80 |
$421.00
|
|
Umbilicoplasty 15847
|
$80,127.30 |
$80,127.30 |
$80,127.30 |
$4,172.97
|
|
Unit mobile power mpu
|
$11,821.68 |
$11,821.68 |
$11,821.68 |
$14,359.52
|
|
Unlisted laparoscopic liver biopy 47379
|
$78,897.61 |
$78,897.61 |
$78,897.61 |
$6,307.38
|
|
Unlisted procedure microbiology
|
$507.00 |
$507.00 |
$507.00 |
$530.00
|
|
Unlisted px lacrimal system
|
$39,927.35 |
$39,927.35 |
$39,927.35 |
$416.50
|
|
Unlstd laps px sprmatic cord
|
$62,536.66 |
$62,536.66 |
$62,536.66 |
$4,713.11
|
|
Unsched dialysis esrd pt hos
|
$971.75 |
$971.75 |
$971.75 |
$1,296.00
|
|
Upper Arm (Humerus) X-ray (left side)
|
$761.00 |
$761.00 |
$761.00 |
$309.31
|
|
Upper Back (Thoracic Spine) CT Scan (with contrast)
|
$1,733.55 |
$1,733.55 |
$1,733.55 |
$1,669.00
|
|
Upper Back (Thoracic Spine) CT Scan (without contrast)
|
$1,542.45 |
$1,542.45 |
$1,542.45 |
$1,425.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$1,643.20 |
$1,643.20 |
$1,643.20 |
$2,998.00
|
|
Upper Back (Thoracic Spine) MRI (without contrast)
|
$1,033.50 |
$1,033.50 |
$1,033.50 |
$2,034.41
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$248.95 |
$248.95 |
$248.95 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$89.70 |
$89.70 |
$89.70 |
$381.60
|
|
Upper Endoscopy (EGD, diagnostic)
|
$10,469.95 |
$10,469.95 |
$10,469.95 |
$1,824.75
|
|
Upper Endoscopy (EGD, with biopsy)
|
$17,156.61 |
$17,156.61 |
$17,156.61 |
$1,768.00
|
|
Upper GI Barium X-ray (barium and gas)
|
$619.45 |
$619.45 |
$619.45 |
$660.40
|
|
Upper GI Barium X-ray (barium only)
|
$447.85 |
$447.85 |
$447.85 |
$607.20
|
|
Urea nitrogen
|
$729.00 |
$729.00 |
$729.00 |
$42.01
|
|
Urea nitrogen 24 hour urine
|
$42.90 |
$42.90 |
$42.90 |
$51.84
|
|
Ureteral reflux study
|
$567.00 |
$567.00 |
$567.00 |
$952.50
|
|
Urethrcystgrphy rtrgrde s&i
|
$596.05 |
$596.05 |
$596.05 |
$584.00
|
|
Urethrocystography void s&i
|
$619.45 |
$619.45 |
$619.45 |
$634.50
|
|
Uric acid blood
|
$40.95 |
$40.95 |
$40.95 |
$49.32
|
|
Uric acid urine
|
$163.15 |
$163.15 |
$163.15 |
$44.52
|
|
Urinalysis microscopic only
|
$37.05 |
$37.05 |
$37.05 |
$26.35
|
|
Urinalysis (with microscopy)
|
$659.00 |
$659.00 |
$659.00 |
$55.20
|
|
Urinalysis (without microscopy)
|
$599.00 |
$599.00 |
$599.00 |
$35.91
|
|
Urinary bldr retent nuc study
|
$567.00 |
$567.00 |
$567.00 |
$350.66
|
|
Urine Culture Test
|
$451.00 |
$451.00 |
$451.00 |
$82.32
|
|
Urine pregnancy test
|
$73.45 |
$73.45 |
$73.45 |
$68.21
|
|
Ustekinumab 130 mg/26 ml intravenous solution
|
$6,677.00 |
$6,677.00 |
$6,677.00 |
$5,205.00
|
|
Ustekinumab 45 mg/0.5 ml subcutaneous solution
|
$45,913.60 |
$45,913.60 |
$45,913.60 |
$51,633.07
|
|
Vaccine Administration (one shot)
|
$39.65 |
$39.65 |
$39.65 |
$67.74
|
|
Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml
|
$286.65 |
$286.65 |
$286.65 |
$224.25
|
|
Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml
|
$559.65 |
$559.65 |
$559.65 |
$209.40
|
|
Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im
|
$341.00 |
$341.00 |
$341.00 |
$236.50
|
|
Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im
|
$68.90 |
$68.90 |
$68.90 |
$123.20
|
|
Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im
|
$52.00 |
$52.00 |
$52.00 |
$80.15
|
|
Vaccine dtap < 7 years im
|
$142.05 |
$142.05 |
$142.05 |
$71.17
|
|
Vaccine dtap-hep b-ipv im
|
$513.00 |
$513.00 |
$513.00 |
$164.63
|
|
Vaccine dtap-ipv 4-6 years im
|
$142.00 |
$142.00 |
$142.00 |
$105.95
|
|
Vaccine dtap-ipv-hib-hepb im
|
$135.20 |
$135.20 |
$135.20 |
$174.72
|
|
Vaccine dtap-ipv/hib im
|
$103.35 |
$103.35 |
$103.35 |
$221.24
|
|
Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im
|
$39.00 |
$39.00 |
$39.00 |
$70.53
|
|
Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im
|
$37.05 |
$37.05 |
$37.05 |
$43.12
|
|
Vaccine hepatitis a (hepa) adult im
|
$157.00 |
$157.00 |
$157.00 |
$166.62
|
|
Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im
|
$124.80 |
$124.80 |
$124.80 |
$231.56
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im
|
$87.00 |
$87.00 |
$87.00 |
$78.25
|
|
Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im
|
$48.10 |
$48.10 |
$48.10 |
$57.20
|
|
Vaccine hepatitis b (hepb) adolescent 2 dose im
|
$57.20 |
$57.20 |
$57.20 |
$90.35
|
|
Vaccine hepatitis b (hepb) adult 3 dose im
|
$345.70 |
$345.70 |
$345.70 |
$155.16
|
|
Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im
|
$326.30 |
$326.30 |
$326.30 |
$274.93
|
|
Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im
|
$138.80 |
$138.80 |
$138.80 |
$75.39
|
|
Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im
|
$686.00 |
$686.00 |
$686.00 |
$576.48
|
|
Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im
|
$226.20 |
$226.20 |
$226.20 |
$282.50
|
|
Vaccine influenza (iiv) preservative free antigen content im
|
$149.50 |
$149.50 |
$149.50 |
$149.21
|
|
Vaccine influenza inactivated adjuvant im
|
$303.40 |
$303.40 |
$303.40 |
$110.25
|
|
Vaccine influenza nos 0.5ml dose im
|
$21.45 |
$21.45 |
$21.45 |
$24.20
|
|
Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im
|
$530.00 |
$530.00 |
$530.00 |
$48.59
|
|
Vaccine influenza quadrivalent (iiv4) 0.5ml dose im
|
$42.90 |
$42.90 |
$42.90 |
$35.88
|
|
Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im
|
$157.95 |
$157.95 |
$157.95 |
$72.80
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im
|
$20.80 |
$20.80 |
$20.80 |
$28.77
|
|
Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im
|
$45.50 |
$45.50 |
$45.50 |
$33.60
|
|
Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im
|
$22.10 |
$22.10 |
$22.10 |
$20.80
|
|
Vaccine influenza quadrivalent live (laiv4) intranasal
|
$56.55 |
$56.55 |
$56.55 |
$37.05
|
|
Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im
|
$149.50 |
$149.50 |
$149.50 |
$72.00
|
|
Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im
|
$524.55 |
$524.55 |
$524.55 |
$82.71
|
|
Vaccine influenza trivalent (iiv3) 0.25ml dose im
|
$32.50 |
$32.50 |
$32.50 |
$23.20
|
|
Vaccine mengingoccocal serogroup b 2 dose im
|
$499.00 |
$499.00 |
$499.00 |
$394.26
|
|
Vaccine mengingoccocal serogroup b 2 or 3 dose im
|
$169.00 |
$169.00 |
$169.00 |
$409.35
|
|
Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im
|
$149.50 |
$149.50 |
$149.50 |
$310.93
|
|
Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im
|
$401.05 |
$401.05 |
$401.05 |
$327.37
|
|
Vaccine mmr live subcutaneous
|
$466.05 |
$466.05 |
$466.05 |
$213.00
|
|
Vaccine mmrv live subcutaneous
|
$619.00 |
$619.00 |
$619.00 |
$424.32
|
|
Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im
|
$556.15 |
$556.15 |
$556.15 |
$252.87
|
|
Vaccine pneumococcal conjugate 13 valent (pcv13) im
|
$524.55 |
$524.55 |
$524.55 |
$393.25
|
|
Vaccine pneumonococcal conjugate 15 valent (pcv15) im
|
$501.15 |
$501.15 |
$501.15 |
$414.46
|
|
Vaccine pneumonococcal conjugate 20 valent (pcv20) im
|
$1,647.00 |
$1,647.00 |
$1,647.00 |
$563.36
|
|
Vaccine polio (ipv) subcutaneous/im
|
$100.00 |
$100.00 |
$100.00 |
$90.70
|
|
Vaccine rabies im
|
$2,371.90 |
$2,371.90 |
$2,371.90 |
$858.95
|
|
Vaccine respiratory syncytial virus bivalent subunit/preservative free im
|
$658.00 |
$658.00 |
$658.00 |
$538.84
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im
|
$1,159.00 |
$1,159.00 |
$1,159.00 |
$1,105.21
|
|
Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im
|
$1,159.00 |
$1,159.00 |
$1,159.00 |
$997.44
|
|
Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im
|
$250.90 |
$250.90 |
$250.90 |
$499.62
|
|
Vaccine rotavirus attenuated (rv1) live 2 dose oral
|
$309.00 |
$309.00 |
$309.00 |
$200.70
|
|
Vaccine rotavirus pentavalent (rv5) live 3 dose oral
|
$102.70 |
$102.70 |
$102.70 |
$126.14
|
|
Vaccine tdap >=7 years im
|
$761.00 |
$761.00 |
$761.00 |
$131.34
|
|
Vaccine td preservative free >= 7 years im
|
$211.80 |
$211.80 |
$211.80 |
$112.10
|
|
Vaccine typhoid vicps im
|
$312.00 |
$312.00 |
$312.00 |
$264.78
|
|
Vaccine varicella live subcutaneous
|
$960.60 |
$960.60 |
$960.60 |
$365.17
|